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Improving Responses to People with Mental Illnesses - The Essential Elements of Specialized Probation Initiatives

A report prepared by the Council of State Governments Justice Center for the National Institute of Corrections, U.S. Department of Justice, Federal Bureau of Prisons - Seth J. Prins & Fred C. Osher, M.D.


Acknowledgments v

Introduction vii

Ten Essential Elements

1 | Collaborative Planning and Administration 1

2 | Defining, Identifying, and Assessing a Target Population 3

3 | Designing the Initiative and Matching

Individuals to Supervision and Treatment Options 6

4 | Setting Conditions of Community Supervision 9

5 | Developing an Individualized Case Plan 11

6 | Providing or Linking to Treatment and Services 13

7 | Supporting Adherence to Conditions of

Community Supervision and Case Plans 15

8 | Providing Specialized Training and Cross-training 18

9 | Sharing Information and Maintaining Confidentiality 20

10 | Conducting Evaluations and Ensuring Sustainability 22

Conclusion 24

The Essential Elements of Specialized Probation Initiatives v


This publication was made possible through the

leadership and support of the National Institute

of Corrections (NIC), U.S. Department of Justice.

In particular, the Justice Center thanks Morris

Thigpen, Director; Thomas Beauclair, Deputy

Director; George Keiser, Chief of the Community

Corrections Division; and Mike Dooley, Correctional

Program Specialist.

The Council of State Governments Justice

Center would also like to thank the members of

this publication’s advisory group, listed below,

who reviewed drafts of the document. A subset

of the advisory group (indicated by an asterisk)

met in September 2008 to discuss their reactions

to an earlier iteration.

• Mr. Thomas Beauclair, Deputy Director,

National Institute of Corrections

• Mr. Brad Bogue, President, Justice System

Assessment and Training*

• Ms. Carole Carothers, Executive Director,

NAMI Maine*

• Dr. Valerie Chakedis, Director of Diversion,

Re-Entry and Community Education, New York

State Office of Mental Health*

• Mr. Bryan Crocker, Assistant District Attorney,

Mecklenburg County (NC)*

• Ms. Cheryl Frenette, Probation Supervisor

(Ret.), Denver (CO) Adult Probation


• Ms. LaVerne Miller, Senior Project Associate,

Policy Research Associates*

• Hon. Brent Moss, Judge, Bonneville County

(ID) Mental Health Court*

• Mr. Timothy Murray, Executive Director,

Pretrial Justice Institute*

• Dr. Geraldine Nagy, Director, Travis County

(TX) Adult Probation Department*

• Mr. Dave Norman, Staff Attorney, Public

Defender Service, Mental Health Division,

District of Columbia*

• Mr. Jeff Walters, President and CEO, Rushford

Center (CT) and Secretary-Treasurer, National

Council for Community Behavioral Healthcare*

The authors also thank Carl Wicklund, Executive

Director of the American Probation and Parole

Association; Michael Thompson, Director of the

Council of State Governments Justice Center; and

Nancy Fishman, Director of the Justice Center’s

Criminal Justice/Mental Health Consensus Project

for their valuable feedback. Finally, the authors

are grateful to Katharine Willis and Regina Davis

for their careful copyediting.

The Essential Elements of Specialized Probation Initiatives vii


Probation officers across the country—already facing staggeringly large caseloads and expanding workloads—are supervising unprecedented numbers of people with mental illnesses, most of whom have co-occurring substance use disorders.

This population has extensive treatment and service needs and requires supervision strategies that traditional probation agencies were not designed to provide.1 Probation supervision, however, represents a crucial window of opportunity to link people with mental illnesses to treatments and services that can help them avoid re-arrest and reincarceration and ultimately become contributing members of their communities. But all too often this opportunity is missed: people with mental illnesses are nearly twice as likely as others under supervision to have their community sentence revoked, deepening their involvement in the criminal justice system.2 These revocation rates also confirm what many probation administrators and community treatment providers already know to be true—that inadequate or inappropriate responses to this group can heighten risks to individual and public safety, miss crucial public health opportunities, and make inefficient use of taxpayer dollars.

As a growing number of communities grapple with implementing specialized probation responses, there is a commensurate demand for more information on the key components, or elements, that communities should consider and address to successfully implement such an initiative.

This report articulates 10 essential elements for all probation interventions that involve people with mental illnesses, regardless of the particular program model. The elements are intended to provide practitioners and policymakers with a common framework for designing and implementing an initiative that will achieve positive outcomes while being sensitive to every jurisdiction’s distinct needs and resources.

About the Problem

The reasons why increasingly large numbers of people with mental illnesses become entrenched in the criminal justice system generally, and the probation system specifically, are complex and involve multiple systemic and individual factors.3

It is clear, however, that once people with mental illnesses are under probation supervision, it can be extremely difficult for them to succeed in the community. This difficulty may be linked to their mental illnesses in a number of ways:

• They might be unable to access treatment, decompensate, and then be arrested for disturbing or dangerous public behavior;

• Functional impairments may make it difficult for them to comply with standard conditions of release, such as maintaining employment and paying fines;

• Their federal benefits (in particular, Medicaid coverage of pharmacy costs), which were probably terminated rather than suspended upon incarceration, were not reinstated immediately upon release;

• They often have unaddressed risk factors associated with criminal behavior and increased public safety concerns, such as antisocial peers or attitudes;

• Probation officers may monitor them exceptionally closely and report technical violations readily because they mistakenly believe that people with mental illnesses are more likely to be violent.

1. Some portions of this document draw heavily from the Justice Center’s Improving Outcomes for People with Mental Illnesses under Community Corrections Supervision: A Guide to Research- Informed Policy and Practice (New York: Council of State Governments Justice Center, 2009), which was developed on a parallel track.

2. Dauphinot, L. “The Efficacy Of Community Correctional Supervision For Offenders With Severe Mental Illness” (PhD. diss., University of Texas at Austin, 1996); Skeem, J., and J. E. Louden, “Toward Evidence-based Practice for Probationers and Parolees Mandated to Mental Health Treatment,” Psychiatric Services 57 (2006); Porporino, F. J., and L. Motiuk, “The Prison Careers of Mentally Disordered Offenders,” International Journal of Law and Psychiatry 18 (1995): 29–44; Messina, N., W. Burdon, G. Hagopian, and M. Prendergast. “One Year Return to Custody Rates among Co-disordered Offenders,” Behavioral Sciences and the Law 22 (2004): 503–18.

3. To learn more about the overrepresentation of people with mental illnesses in the criminal justice system, see Council of State Governments. Criminal Justice/Mental Health Consensus Project (New York: Council of State Governments. June 2002),

Compounding these challenges, traditional probation supervision strategies and techniques may make it even more difficult for people with mental illnesses to succeed in the community.

Some agencies may view their role solely as monitors of compliance and not consider that addressing their supervisees’ complex treatment and service needs can be integral to maintaining public safety and reducing recidivism. In some jurisdictions, challenges to supervising this population (for example, the increased time and energy this group frequently requires) may be perceived as disincentives for probation officers to keep people with mental illnesses on their caseloads. In such jurisdictions, the traditional probation response contributes to poor outcomes for these individuals.

From the perspective of over-burdened probation officers, the complicated circumstances and comprehensive needs of people with mental illnesses can represent a nearly insurmountable challenge. Officers’ caseloads can reach into the hundreds, and their workloads (for example, the number of supervision conditions for which they must ensure compliance) have also increased.

They typically do not receive the resources or training to collaborate with community-based treatment providers, monitor individuals’ compliance with

Pre-Trial Release

There are a variety of pre-trial interventions that avoid court-ordered supervision for people with mental illnesses when appropriate. In these circumstances, the criminal justice and mental health systems can collaborate before an individual with mental illness is convicted of an offense, so that conviction and sentencing are not the mechanisms that trigger linkages to appropriate treatments and services.

Successful adherence to the terms of these pre-trial interventions (which often include mandated treatment) can then result in reduced or dismissed charges. For example, police-based responses can link people with mental illnesses to treatment without processing charges. Mental health courts can supervise conditions of release without corrections involvement.

In many cases, probation agencies may be involved with pre-trial services. Probation officers may help monitor the conditions of pre-trial release for people with mental illnesses who are charged with minor offenses and who prosecutors, attorneys, and judges agree should not become further involved with the criminal justice system. Pre-trial programs that involve probation agencies are beyond the scope of this document, but the authors encourage policymakers to consider these and other “frontend” interventions that prevent an appropriate subset of individuals from becoming entrenched in the criminal justice system altogether.

For further reading on these and related issues, please see Improving Responses to People with Mental Illnesses: The Essential Elements of a Specialized Law Enforcement-Based Program and Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court available at

The Essential Elements of Specialized Probation Initiatives ix

treatment, and watch for potentially harmful or

dangerous behaviors.4 From the perspective of

equally over-burdened mental health treatment

providers, coordinating both the legal and clinical

issues of people with mental illnesses under

probation supervision presents a challenge—

made even more daunting by the large number

of clients without justice involvement competing

for the same scarce resources.

Specialized Probation


Many community corrections officials and their

counterparts in the mental health system understand

that their target populations—and their public

safety and public health missions—overlap, and

that the need for new approaches has never been

greater. Across the country, a growing number of

probation officials are working with law enforcement

officers, jail and prison administrators,

judges, prosecutors, defense attorneys, and community-

based treatment providers to develop

strategies that maintain public safety while

improving outcomes for people with mental illnesses

under probation supervision.

This heterogeneous group often faces a variety

of challenges. They face clinical conditions,

functional impairments, socioeconomic challenges,

and criminal charges or convictions of

varying severity, and they pose different degrees

of risk to public safety. Probation strategies and

interventions designed to improve outcomes for

this diverse group are therefore wide-ranging

and can be spearheaded by probation systems,

community-based mental health systems, or

collaboratively by both systems. The essential

elements outlined in this document apply to

specialized probation responses to people with

mental illnesses that are delivered in any of these

three ways, but focus primarily on initiatives in

which participants have been adjudicated and

sentenced to participate, with conditions, in a

specialized probation initiative after or in lieu of

a jail term.

About the Elements

Each of the 10 essential elements contains a short statement (in italics) describing criteria that specialized probation initiatives should meet in order to be effective, followed by an explanation

4. See Policy Statement 22, Council of State Governments Justice

Center. Criminal Justice/Mental Health Consensus Project Report

(New York: Council of State Governments Justice Center,


This document focuses squarely on locally administered probation responses to people with mental illnesses; however, it may have utility for those interested in specialized parole or other types of community supervision. Individuals with mental illnesses under parole supervision have much in common with those under probation supervision. Both groups share similar challenges to reentry and may

even compete for the same limited resources.

In some jurisdictions the same community

corrections officers provide supervision for

both populations. Nevertheless, there are

issues unique to parole populations and parole

responses that this document does not explicitly address.

For information on strategies to improve

outcomes for all individuals on parole (not

people with mental illnesses specifically), please

see Solomon, A. L., Jenny W. L. Osborne, Laura

Winterfield, Brian Elderbroom, Peggy Burke,

Richard P. Stroker, Edward E. Rhine, and William

D. Burrell. Putting Public Safety First: 13 Parole

Supervision Strategies to Enhance Reentry Outcomes.

Generalizing from Specialized Probation to Parole

x Improving Responses to People with Mental Illnesses

5. Although this document is intended to assist in the design

and implementation of programmatic interventions for people

with mental illnesses under probation supervision, there may

be state legislative or statutory issues that policymakers must

address before such programs can be effectively developed.

For more information on improving community corrections

at the state level, including full provisions and suggested

language for legislation, please see The Public Safety

Performance Project of the Pew Center on the States.

Policy Framework to Strengthen Community Corrections

(Washington: The Pew Charitable Trusts, 2008).

of the element’s importance and how its principles

can be achieved. All of the elements rest

on two key assumptions. First, each element

depends on meaningful collaboration among

professionals in the criminal justice and mental

health systems. Although achieving the requisite

level of collaboration is often difficult—particularly

when faced with long-standing systemic or

cultural barriers—successful partnerships are

needed to carry out each element. Second, probation

represents only one “intercept point” for

individuals with mental illnesses who have been

in contact with law enforcement, courts, jails,

and, in some cases, prisons. To address problems

raised by the large number of people with

mental illnesses in the criminal justice system,

a comprehensive community- and system-wide

strategy in which specialized probation interventions

play only one part is required. Therefore,

such an initiative’s impact on other components

of the criminal justice and community mental

health systems must be considered during the

planning and implementation process.

This report is meant to guide agents of change

in communities that want to develop a specialized

probation intervention. As such, it can be used

as a practical planning tool at each stage of the

process (designing the initiative, developing or

enhancing policies and procedures, monitoring

practices, and conducting evaluations).5 It can

also be used by personnel from seasoned, longstanding

initiatives to improve the organization

and functioning of an existing effort. The Essential

Elements is intended to be a “living document”

that will be updated or supplemented as specialized

probation responses mature, incorporating

new research findings that can provide a stronger

base of knowledge about how these initiatives

can best operate, their impact on the community,

and the relative importance of each of the essential



The essential elements are based on information

from a variety of sources, including the

experiences of probation officials, mental health

professionals, advocates, and consumers of mental

health services, as well as a review of the

scholarly and policy literature. A panel of national

experts composed of policymakers and practitioners

guided early drafts of this document. They also

gathered at an advisory meeting in September

2008 to review, discuss, and debate each element

in depth. Comments and suggestions from the

advisory meeting and from subsequent reviews

by other national experts, are reflected in this


The Essential Elements of Specialized Probation Initiatives 1

Specialized probation responses to people with

mental illnesses occur at the intersection of the

criminal justice, mental health/substance use

treatment, and social service systems. Their planning

and implementation should reflect extensive

collaboration among policymakers and practitioners

from each of these fields who have the

authority to implement significant changes in

their agencies’ policies, procedures, funding, and

staffing. A planning committee should be convened

by an official (or officials) with the respect

and stature to encourage these changes.6

People with mental illnesses under probation

supervision have been in contact with law

enforcement, courts, and/or jails. Their mental

illnesses may be known to these agencies,

either from self-reporting or through screening

and assessment procedures. A judge, in consultation

with prosecutors and defense attorneys,

likely determined the conditions of their supervision.

Community-based providers may have

treated many of these individuals and appropriately

shared information about their diagnoses,

psychotropic medications, and treatment plans

with court, jail, and probation staff. For others,

contact with the criminal justice system may be

the first time they have been assessed as having

a mental illness and linked to community treatment

and support services. Because the operation

of a specialized probation response is linked so

closely with the operations of these and other

agencies and systems, the planning committee

should include—at minimum—probation

agency directors and officers, jail administrators/

sheriffs, jail staff, judges, pre-trial services staff,

prosecutors, defense attorneys, law enforcement

officials, mental health and substance use treatment

agency directors and case workers, and

individuals with mental illnesses and their family members.

In addition to this core group, the planning

committee should include advocates, victims of

crime committed by people with mental illnesses,

housing agencies, and other community stakeholders

to reflect and integrate broader efforts

The Essential Elements

1 collaborative planning and administration

A multidisciplinary committee of elected and appointed officials, agency administrators

and their staffs, treatment providers, consumers of mental health services, and other

community stakeholders—representing the criminal justice, mental health, substance

use treatment, and social service systems—work together to articulate the goals and

objectives of the specialized probation initiative and guide the design, implementation,

and oversight of the initiative.

6. This element can be adapted to well-established, operational

initiatives whose planning has long since concluded. If

the planning process for such programs did not initially

consider aspects of this element, program administrators are

encouraged to adapt the element to the ongoing oversight and

administration of their initiative.

2 Improving Responses to People with Mental Illnesses

7. For example, a jail policy of providing only three days’

worth of an individual’s medications upon release might be

inconsistent with a program goal of ensuring continuity of

care from incarceration to community supervision.

to improve outcomes for people with mental illnesses

involved in the criminal justice system.

The composition of the planning committee

raises two critical issues that each community

must resolve in its own way. First, there are key

local and state agencies in every jurisdiction

whose absence from the initial planning process

may complicate all subsequent activities.

Second, and conversely, in many jurisdictions

there may be key stakeholders who present

obstacles to collaborative efforts, even when

included in the planning process from the beginning.

Resolving these issues requires strong

leadership and effective tactics that will differ

by locale. If obstacles arise from the competing

interests of different stakeholders (for example

between the public defenders and prosecutors),

tackling these issues, identifying shared goals,

and devising appropriate compromises can actually

strengthen collaborations—and initiative

design—in the end.

The planning committee should examine the

particular issues facing its community; identify

clear, specific, and measurable goals and objectives

to address them; and consider how they will

measure (and others will evaluate) their progress.

This will entail early consideration of key process

and outcome data (see Element 10). Committee

members, in collaboration with other partners,

should also assess gaps in services and identify

mechanisms to address them. In so doing, the

committee should also determine how it will

relate to other criminal justice/mental health

boards or task forces that may already exist at the

local and state levels.

The next step is to develop processes for

determining the initiative’s clinical and legal

eligibility criteria, supervision conditions, and

treatment/service linkages. It should also develop

a review process to ensure the policies and procedures

of all relevant agencies and organizations

are consistent with the goals and objectives of

the specialized probation response.7

The planning committee should also identify

the lead agency or agencies that will administer

the initiative’s day-to-day activities, train probation

officers and community treatment providers,

measure the initiative’s progress toward achieving

stated goals, and resolve ongoing challenges

to effectiveness. Administrators should report

back regularly to the planning committee, which

can advise on adjustments to the initiative’s

policies, procedures, and operations where

appropriate, and assist in keeping key policymakers,

the media, and the community-at-large

informed of initiative costs, developments, and


To overcome challenges inherent in crosssystem

collaboration, including staff turnover

and leadership changes, policies and procedures

should be institutionalized to the greatest extent

possible. Interagency memoranda of understanding

(MOUs) can be developed to address

key issues such as which resources each organization

will commit and what information can be

shared through identified mechanisms.

The Essential Elements of Specialized Probation Initiatives 3

8. This paragraph is adapted from Prins, S. J., and Draper, L.

Improving Outcomes For People With Mental Illnesses Under

Community Corrections Supervision: A Guide To Research-

Informed Policy And Practice (New York: Council of State

Governments Justice Center, 2009).

9. Ibid.

10. National Association of State Mental Health Program

Directors and National Association of State Alcohol and Drug

Abuse Directors. National Dialogue on Co-occurring Mental and

Substance Abuse Disorders (Alexandria, VA and Washington,


11. Coordination exists when each agency is aware of the other’s

activities and occasionally shares clinical or legal information

Specialized probation responses can accommodate

only a small percentage of people with

mental illnesses involved in the criminal justice

system; they are one intervention within a

comprehensive set of strategies to provide law

enforcement, court, and corrections systems with

options other than arrest, detention, and sentenced

supervision for this population. Understood in

this broader context, careful consideration must

be given to determining eligibility to participate

in such initiatives.

Individuals with mental illnesses under

community corrections supervision are a heterogeneous

group. They pose different degrees

of criminogenic risk, determined by the nature

of their offense; dynamic factors associated with

their attitudes, circumstances, and patterns of

thinking; and public safety concerns. These

individuals also have a wide range of functional

impairments determined in part by diagnoses,

disabilities, and circumstances. Criminogenic risk

and functional impairment are core components

in the design of traditional supervision and treatment

strategies, respectively. As such, it follows

that the range of specialized supervision and

treatment options for this population should be

derived from an assessment of these two basic

dimensions, and the planning committee must

carefully choose a subset of individuals who will

be eligible for participation in the specialized

probation initiative based on these factors.8

Figure 1 illustrates this concept.9 The chart,

derived from similar efforts to organize responses

to people with co-occurring mental illnesses and

substance use disorders,10 highlights the central

considerations that drive criminal justice

and mental health system responses. Although it

has not been validated, it provides a conceptual

approach for matching supervision and treatment

options to varying degrees of criminogenic risk

and functional impairment, both of which can

range from low (nominal) to high (severe). Figure

1 proposes that the level of response intensity and

the degree of coordination/integration between

probation and mental health agencies should

increase as both criminogenic risk and functional

impairment increase.11 The chart suggests

reserving the most resource-intensive specialized

2 defining, identifying, and

assessing a target population

Criminal justice and mental health agencies jointly define legal and clinical eligibility

criteria to select a subset of individuals whose placement in limited specialized probation

supervision slots will have the biggest impact on public safety, spending, and health.

Potential participants are identified at intake to a jail facility and/or upon transition

to probation supervision by staff qualified to administer standardized and validated

screening instruments, followed by standardized and validated clinical and risk

assessment procedures.

4 Improving Responses to People with Mental Illnesses

about particular individuals in contact with both agencies.

Integration exists when community corrections and mental

health agencies develop and implement a single supervision

and treatment plan, share responsibility for this supervision

and treatment, share staff and other resources, and participate

in each other’s case staffing. Adapted from Center for

Substance Abuse Treatment. Definitions and Terms Relating

to Co-occurring Disorders: COCE Overview Paper 1, DHHS

Publication No. SMA 06-4163 (Rockville, MD: Substance

Abuse and Mental Health Services Administration, Center

for Mental Health Services, 2006).

probation packages for those individuals with

the highest levels of risk and impairment (that

is, the highest risk of recidivism). The chart also

assumes that relevant criminal justice and mental

health agencies can collect and track data on

the different subsets of individuals in their systems

to determine which group to focus on based

on community-relevant factors (see Elements 3

and 10 for discussions on data collection).

When defining a target population, key considerations

should be the availability of treatments

and support services in the community, the

state’s definition of its “priority population” for

publicly funded mental health services, and the

capacities and competencies of relevant agency

staff. These factors help narrow the focus of the

initiative to a subgroup of individuals who, when

provided effective treatment and supervision,

can achieve the greatest public safety and public

health outcomes.

Determining which subgroups to include

will inevitably be informed by addressing questions

about which subgroups to exclude from the

initiative. These questions, the importance of

which should not be underestimated, can take a

number of forms: “Is there a certain threshold

Fig. 1: Identifying target populations by criminogenic risk and functional impairment





Intensive treatment

in collaboration with


Integrated supervision and

treatment strategies

Treatment and supervision

coordinated as needed

Intensive supervision

in collaboration with




The Essential Elements of Specialized Probation Initiatives 5

12. Ideally, jurisdictions would employ electronic jail information

systems that can be adapted to code screening categories for

mental illnesses and provide monthly reports on the number

of people screened into these different groups. This is critical

in determining whether adequate resources are available

for the specialized probation intervention, and if they are

not, determining how to re-focus on a particular group. The

probation agency should also ideally have an electronic case

tracking system in which key data elements can be captured

to identify individuals who have participated in the specialized

probation intervention and those who have not. This will allow

for process and outcome research to refine the initiative. For

many jurisdictions, however, obtaining and implementing

advanced electronic information systems is not currently


13. Goldberg, A. L., and B. R. Higgins. “Brief Mental Health

Screening for Corrections Intake,” Corrections Today August,


14. Lowenkamp, C., and E. J. Latessa. “The Risk Principle in

Action: What Have We Learned from 13,676 Offenders and

97 Correctional Programs?” Crime and Delinquency 51 (2006):

1–17, as cited in The Public Safety Performance Project of

the Pew Center on the States. Policy Framework to Strengthen

Community Correction. (Washington: The Pew Charitable

Trusts, 2008).

15. Ridgely, M. S., J. Engberg, M. D. Greenberg, S. Turner,

C. DeMartini, and J. W. Dembosky. Justice, treatment, and cost:

An evaluation of the fiscal impact of Allegheny County Mental

Health Court (Santa Monica: Rand Corporation, 2007),

of criminogenic risk and functional impairment

at which community resources can no longer be

effective, or at which political support will evaporate?”

“Are there specific charges (for example,

sexual offenses) or circumstances (for example, citizenship

status) that require different responses?”

The planning committee must carefully deliberate

about these issues.

Once the planning committee defines the

target population based on the key dimensions

above, it should ensure that this definition

is communicated to the court, jail, probation

agency, and community treatment providers—

which may have different classification systems,

diagnostic categories, and treatment priorities—

to encourage collaboration based on a common

understanding of the program’s goals and who

would benefit most from the specialized initiative.

Policies and interagency protocols should

be in place to ensure all relevant agencies are

using similar standardized, validated, and easyto-

administer screening instruments to identify

individuals who fit the eligibility criteria.12

Instruments such as the Brief Jail Mental Health

Screen and the Correctional Mental Health Screen

are short and accurate and can replace outdated

instruments—or be incorporated into existing

procedures—with relative ease.13 Qualified personnel

must then use standardized and validated

clinical and risk assessment procedures to determine

the specific needs of people who “screen

positive,” and identify the subset of people who

meet the initiative’s eligibility criteria.

This is not to say that standardized screening

and assessment processes create a rigid

“scoring rubric” for inclusion or exclusion in the

specialized probation initiative. The processes

are the objective filters used to identify potential

participants. Participation will ultimately be at

the discretion of prosecutors, public defenders,

judges, probation officials, and community-based

treatment providers.

In addition to its obvious impact on the

specialized probation initiative’s design and

implementation, eligibility criteria also play a

central role in determining whether the initiative,

once operational, is meeting its stated goals and

objectives. Focusing on individuals with certain

needs and risks can have a differential impact on

public safety, public spending, and public health

outcomes. For example, using intensive supervision

and treatment strategies to target low-risk,

low-impairment individuals who have committed

minor offenses may actually increase recidivism

rates for this population as officers observe

minor technical violations that would otherwise

go unnoticed.14 This increased scrutiny may mitigate

potential cost savings to the community as

supervisees are returned to expensive jail beds;

in fact, a focus on a target population with these

characteristics may be more expensive than the

status quo.15 In contrast, supervising individuals

charged with more serious offenses may avert a

larger number of jail stays, but may also require

more concerted political will to assuage the perceived—

but not validated—increase in risk to

public safety.

6 Improving Responses to People with Mental Illnesses

16. For example, participants with low criminogenic risk and low

functional impairment may require little (or no) supervision

and less intensive outpatient mental health treatment.

Community corrections and mental health staff may not need

to coordinate extensively, dedicate additional resources, or

change the setting in which supervision and treatment are

provided if both systems are implementing good, routine

practices. People with low risk/high impairments or high risk/

low impairments may require coordination between probation

and mental health staff, but not full-fledged integration. These

groups may also require mental health agencies to take the

lead and coordinate with probation, or probation agencies to

take the lead and coordinate with mental health treatment

providers, respectively. Intensive, integrated interventions

should be reserved for those with high criminogenic risk and

high functional impairment.

17. Lurigio, A. J., I. C. Young, J. A. Swartz, T. P. Johnson, I. Graf,

and L. Pickup. “Standardized Assessment of Substancerelated,

Other Psychiatric, and Comorbid Disorders among

Probationers,” International Journal of Offender Therapy

and Comparative Criminology 47 (2003): 630–52; Skeem, J.,

E. Nicholson, and C. Kregg. March 2008. “Understanding

Barriers to Re-entry for Parolees with Mental Disorder. In

D. Kroner (Chair), Mentally disordered offenders: A special

population requiring special attention (Jacksonville: Symposium

conducted at the meeting of the American Psychology-Law


18. Ditton, P. M. Mental health and treatment of inmates and

probationers (Washington: Bureau of Justice Statistics, 1999).

19. Ibid.

Participant eligibility criteria should be consistent

with the specialized probation initiative’s

design. There are two broad and related sets of

issues that planners and administrators should

consider. First, they should determine the most

effective combination of treatment and supervision

for the criminogenic risks and functional

impairments of the initiative’s intended target

population. Second, they should determine the

initiative’s participant capacity, that is, its ideal

scale, which will largely depend on the fiscal

realities and availability of resources in a given

community. Decisions regarding these two sets

of issues should be well-documented, and limitations

should be openly acknowledged.

The first set of issues includes the type and

intensity of supervision and treatment that participants

will receive, the degree to which probation

and mental health agencies coordinate or integrate

their responses, and the setting in which

supervision and treatment is provided.16 Systemlevel

obstacles such as the availability of case

management, integrated substance use and mental

health treatment, trauma-specific services,

and housing should also be considered as most

individuals under probation supervision have

multiple issues that require a response including

co-occurring disorders,17 a history of victimization

and other trauma,18 and limited access to

stable housing.19

3 designing the initiative and

matching individuals to supervision

and treatment options

The design of the specialized probation initiative is informed by analyses of the target

population; the policies and procedures of relevant agencies; and available resources,

services, and other supports. The planning committee and initiative administrators

identify agency- and systems-level obstacles to effective probation supervision of people

with mental illnesses and design the specialized initiative to address these issues.

The Essential Elements of Specialized Probation Initiatives 7

20. See Burrell, B. Caseload Standards for Probation and Parole

(Lexington: American Probation and Parole Association,

2006),; DeMichele, M. T.

Probation and Parole’s Growing Caseloads and Work Allocation:

Strategies for Managerial Decision Making (Lexington: American

Probation and Parole Association, 2007), http://www.appa-net.


21. Skeem, J. L., Paula Emke-Francis, and Jennifer Eno Louden.

“Probation, Mental Health, And Mandated Treatment: A

National Survey,” Criminal Justice and Behavior 33 (2006):


22. The Public Safety Performance Project of the Pew Center

on the States. Policy Framework to Strengthen Community

Corrections (Washington: The Pew Charitable Trusts, 2008).

23. In small jurisdictions, however, dedicated caseloads may not

be practical or feasible. Under these circumstances, the central

objective is providing officers with small enough caseloads to

dedicate adequate time to people with mental illnesses under

their supervision.

The planning committee should also review

agency-level policy and procedural obstacles to participants’

supervision and/or treatment, such as

inadequate information-sharing protocols (see

Element 9), if they present barriers to appropriate

coordination or integration. Furthermore, in

some jurisdictions, pre-sentence investigations,

level of charge or offense, plea agreements, strict

sentencing guidelines, victims’ rights statutes,

or other laws may dictate specific conditions of

supervision, the duration of community supervision,

and the impact of successful completion of

a community sentence. Planners and administrators

should work with relevant officials to adjust

these restrictions where appropriate and be clear

on issues around which there can be little flexibility

for the specialized initiative. If officials cannot

be persuaded to remove or modify these sorts of

policy and procedural obstacles for the specialized

initiative, planners and administrators may

need to redefine the initiative’s objectives.

The second set of issues, determined in large

part by probation and mental health agencies’

policies and resources, includes the specialized

initiative’s capacity—that is, caseload size and

composition. The American Probation and Parole

Association has explored caseload standards for

individuals under probation supervision (but not

explicitly for individuals with mental illnesses).20

In general, the number of individuals an officer

supervises should decrease as the overall “case

priority” of their roster increases. Furthermore,

a national survey found that “specialized caseloads”

for people with mental illnesses are smaller

than traditional caseloads, averaging fewer than

50 people per probation officer (as compared to

more than 100 for traditional caseloads).21 That

said, there is no ideal caseload size. The quality

of contacts between probation officers and supervisees

has shown to be more important than the

quantity of contacts.22

Planners need to consider whether caseload

composition should be limited only to people

with mental illnesses. Officers with smaller caseloads

dedicated exclusively to people with mental

illnesses can better monitor their supervisees’

treatment progress.23 This is important because

recovery from mental illnesses is often a cyclical

process; for example, individuals on psychotropic

medications who display low criminogenic

risk and low functional impairment may become

higher risk and more impaired if they stop taking

their medications. Officers with small, dedicated

caseloads will be better able to detect these sorts

of fluctuations and respond in a more targeted,

flexible manner than officers with large, mixed


If planners do not feel they can design an

initiative with appropriate scope and scale due

to agency- and systems-level obstacles such as

those described above, or general funding and

workforce capacity issues, they should reconsider

the initiative’s eligibility criteria or restrict

the number of participants to a pilot project

with expansion dependent on outcomes and

future resources. All too often a perceived lack

of resources can forestall creative planning and

problem solving that considers such issues as

blending funding sources, sharing staff, identifying

in-kind contributions, and public/private/

academic partnerships. Planners and administrators

are encouraged to be realistic and open about

8 Improving Responses to People with Mental Illnesses

24. For more information on systems mapping, please see

Munetz, M. R., and P. Griffin. “Use of the Sequential Intercept

Model as an Approach to Decriminalization of People with

Serious Mental Illness,” Psychiatric Services 57 (2006): 544–49

or the National GAINS Center at http://gainscenter.samhsa.


resource limitations, but not allow them to hinder

exploration of all possible options. Starting

small and building on success can be a useful


Although the basic structure of the initiative

should be informed by research on effective

probation interventions for people with mental

illnesses, administrators (with advice from the

planning committee) will likely need to make

decisions about the integration of treatment and

supervision, caseload size and composition, and

the duration and intensity of supervision and treatment

without the benefit of jurisdiction-specific

research. A “systems mapping” process can complement

any available research and help identify

how people with mental illnesses move through

the criminal justice system (arrest, adjudication,

incarceration, and reentry), where “bottlenecks”

occur, which types of people receive which types

of existing treatment/supervision, and where

gaps need to be filled.24 Planners and administrators

should assess the jurisdiction’s ability to

collect and track new data and revise this systems

map once the initiative is operational. This information

will be critical to initiative sustainability.

The Essential Elements of Specialized Probation Initiatives 9

25. Council of State Governments Justice Center. Criminal Justice/

Mental Health Consensus Project Report (New York: Council of

State Governments Justice Center, 2002).

Conditions of community supervision are the

guideposts for maintaining a law-abiding life and

define individuals’ responsibilities for successful

participation in the specialized probation initiative.

During the design process, including the

selection of a target population, the planning

committee should resolve any of the traditional

factors that determine conditions of community

supervision (for example, pre-sentence

investigations, level of charge or offense, plea

agreements, sentencing guidelines, or victims’

rights statutes) that conflict with initiative goals.

Within the parameters that are ultimately established,

the conditions of community supervision

should be individualized for each supervisee, and

signed by potential participants before they enter

the initiative. They should also be made aware of

the consequences of noncompliance with these

conditions (see Element 7).

Conditions of supervision will likely include

adherence to a case plan (that is, a treatment and

services plan developed for individuals’ transition

from jail to the community or upon being

sentenced to probation). In many jurisdictions,

a judge or prosecutor may make little distinction

between supervision conditions and case plans

and set both at the same time, without involving

probation officers, community-based treatment

providers, or other social services personnel.

Although conditions of supervision and case plans

should inform one another and may ultimately

be packaged together for participants, it is vital

that any personnel involved in “case staffing” be

included in developing each component. Because

case plan design must consider the complex and

multi-systemic social, economic, and clinical

challenges facing people with mental illnesses

involved in the criminal justice system, Element

5 is dedicated to a more complete discussion of

these issues.

Regardless of whether a jurisdiction makes

clear distinctions between supervision conditions

and case plans or treats them synonymously,

a number of general issues should be considered.

First, conditions of supervision should

be the least restrictive necessary and reasonably

calculated to prevent recidivism or further

involvement in the criminal justice system.25

This is especially true for individuals who pose

low risk of future criminal activity; have fewer

service or treatment needs; and have been convicted

of misdemeanors, ordinance offenses, or

other nonviolent crimes. Unlike individuals with

higher criminogenic risk, these individuals may

require less frequent (or no) contacts with their

probation officer. For individuals who have been

convicted of more serious offenses, are at greater

risk of future criminal activity, and have more

4 setting conditions of community


Conditions of community supervision are commensurate with specific criminal charges

and offenses, promote public safety, and are clearly enumerated and accurately conveyed

to supervisees. Conditions facilitate supervisees’ engagement in treatment, are flexible

over changing circumstances, and are individualized according to assessments of public

safety risk and clinical needs.

10 Improving Responses to People with Mental Illnesses

significant clinical needs, their more restrictive

conditions might be relaxed after a predetermined

period of successful adherence. For all

individuals, increases in functionality, decreases

in psychiatric symptoms, and reductions in risk

behaviors should prompt less intensive supervision

regimens, while clinical decompensation

or increases in risk behaviors should trigger

more intensive regimens.

The ability to adjust the restrictiveness and

intensity of supervision conditions depends not

only on their flexibility and individualization but

also on probation officers or other probation officials

having the discretion to modify them based

on their best judgment and special training (see

Element 8). In some jurisdictions, probation officers

are able to make these modifications without

involving the courts; in other jurisdictions, consultation

with judges may be required.

Second, the development of supervision

conditions should be informed by individuals’

ability to understand the responsibilities and

expectations that these conditions carry. There

are important distinctions between the requisite

competency to stand trial and the need to

ensure competency to comply with conditions of

community supervision. Individuals with a high

level of clinical disability and functional impairment

may need clear, written descriptions and

repetitive discussions to fully understand their


Third, regardless of their charges, public safety

risks, or functional impairments, participants

should be aware of the sanctions they will incur

for violating their supervision conditions and the

incentives for ongoing progress (see Element 7).

The parameters for these graduated sanctions

and incentives should be part of the documentation

that individuals sign before they participate

in the initiative. Particularly important are any

distinctions the specialized probation initiative

makes regarding its tolerance for violations of

“control conditions” versus “treatment conditions.”

Control conditions may dictate a very low

tolerance for violations, (for example, a supervisee

attempts to visit a former spouse despite a

condition of supervision that prohibits such an

action), whereas treatment conditions may allow

for infractions without triggering a violation

report to the courts (for example, a supervisee fails

to take some of his or her medication or misses an

appointment with a treatment provider).

Finally, because many supervisees are adjudicated

and granted participation in a specialized

probation initiative after, or in lieu of, a jail term,

it may not be possible to reduce charges or

expunge convictions upon successful completion

of a community sentence; however, when appropriate,

such options should be considered. In

either case, supervisees’ length of participation

in the initiative should not exceed the maximum

sentence they could have received under traditional


The Essential Elements of Specialized Probation Initiatives 11

26. Even if people who will eventually be supervised by probation

agencies were never detained or incarcerated, the period

between their initial contact with the criminal justice system

and their community supervision is equally important. This

element refers to jail transition planning in the interest of

brevity, but still applies to these alternative scenarios.

27. Sabol W. J., and T. D. Minton. Jail Inmates at Midyear 2007

(Washington: Bureau of Justice Statistics, 2008).

28. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice

Approach to Community Re-entry from Jails for Inmates with

Co-occurring Disorders: The APIC Model (New York: The

National GAINS Center, 2002), http://gainscenter.samhsa.


29. Ibid.

30. Ibid.

Although case plans will likely be developed in

conjunction with conditions of community supervision

(as suggested above), they are explored here

as a separate element because they represent a

traditional function of the mental health system,

whose expertise and experience should inform

this aspect of collaboration between the probation

agency and community-based treatment

providers. Furthermore, case plan development

involves multiple agencies beyond the criminal

justice system and should respond to supervisees’

wide-ranging social, economic, and clinical

circumstances. Despite the fact that lengths of

stay in jail can be relatively short compared to

prison terms,26 the time people with mental

illnesses spend in jail after arrest presents a critical

public safety and public health opportunity.

Nearly all of the 13 million people booked into

jails each year will be released,27 many of them

under the supervision of probation agencies.

Within hours of arrest, individuals should be

screened and assessed for mental illnesses and cooccurring

substance use disorders, perhaps for the

first time. Based on the results of screening and

assessment, a judge or team of criminal justice/

mental health staff should determine whether

individuals should be considered for some type

of specialized response, such as pre-trial release

(with or without conditions), a mental health

court or docket, or a specialized probation initiative.

In other cases, judges may decide simply to

place individuals under probation supervision,

and then probation officials may determine who

should become part of their specialized initiative.

Other individuals may serve sentences of less

than a year (although as prisons become more

crowded, jails may hold people for increasingly

longer periods of time).28 Rapid, collaborative

planning among jail, probation, and community

treatment staff is essential to ensure that people

who are entering jail at a high risk of crisis do not

return to the community for supervision in days,

weeks, or months in the same condition—or

worse—to the detriment of any specialized probation


One best-practice model for jail case planning,

“Assess, Plan, Identify, and Coordinate”

(APIC), is practical and research-based.30 It can

be applied to all individuals with mental illnesses

and co-occurring substance use disorders who

5 developing an individualized case plan

The specialized probation initiative, working with jail discharge planners and communitybased

treatment providers, collaboratively develops a treatment and services plan for

individuals transitioning to probation supervision. The case plan is developed as soon as

possible after individuals’ initial contact with the criminal justice system and considers

their criminal charges; public safety risk and functional impairments; treatment, service,

and housing needs; and the resources of both the community corrections agency and

community-based treatment and service providers.

12 Improving Responses to People with Mental Illnesses

31. Ibid.

32. Program planners and administrators should work with

courts, jails, and probation departments to ensure that

these benefits are suspended—and not terminated—during

individuals’ relatively short stays in jail and immediately

reinstated upon release.

33. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice

Approach to Community Re-entry from Jails for Inmates with

Co-Occurring Disorders: The APIC Model (Delmar, NY: The

National GAINS Center, 2002),


spend time in jail, and can be used to develop

plans for the subset of people who are eligible to

participate in the specialized probation initiative.

According to the APIC model, screening and

assessment conducted at intake should be the

first step in developing individualized treatment

and community supervision plans for people with

mental illnesses. Assessment should include

cataloging individuals’ criminogenic risks and

functional impairments; gathering information

from law enforcement, courts, corrections, family

members, and community providers to fully

inform the case plan; understanding issues of

cultural identity, language, gender, and age that

should be addressed in the plan; actively engaging

individuals in identifying their own needs;

and detecting barriers to accessing and paying

for treatment and services in the community.31

After this assessment, staff should develop a

plan that covers the critical period immediately

following individuals’ supervision assignment

and their long-term needs. There are a range of

issues that should be considered and addressed

in different ways depending on the level of criminogenic

risks and functional impairments of the

initiative’s intended target population. These

include housing, food, clothing, transportation,

and childcare; optimal medication regimens,

including sufficient medication to last until individuals’

first appointments and consistent jail

and community treatment agency formularies;

integrated treatment for individuals with cooccurring

substance use disorders; and benefits

applications/reinstatements for SSI/SSDI,

Medicaid, and other entitlements.32

As the case plan is developed, staff should

identify the community-based providers who

will be responsible for treatment, make referrals,

ensure that information-sharing protocols

are in place according to confidentiality statutes

(see Element 9), ensure that victim notification

procedures are followed, and determine treatment

and service agencies’ level of coordination/

integration with the probation officer monitoring

the conditions of supervision.33 The role of probation

agencies may differ depending on where

these individuals fall in terms of their risks to

public safety and clinical needs.

After responsibilities for community-based

services and supervision are identified, staff

from all relevant agencies should coordinate

their efforts. This involves establishing a team

of caseworkers, including probation officers,

treatment providers, court personnel, and others

who meet regularly in “case staffings,” to modify

treatment plans, monitor adherence to the terms

of release, and make changes to these conditions

as appropriate.

Supervisees should be involved in developing

their case plans to the greatest extent possible;

such involvement is thought to increase their

engagement in treatment and supervision and

ultimately their success in the community. The

degree to which supervisees’ preferences are

incorporated into their case plans, however,

should be weighed against the nature of their

criminal charges, criminogenic risks, and functional

impairments. These preferences also

should be balanced against the concerns of

prosecutors, defense attorneys, and judges. For

example, a district attorney or probation official

may not be comfortable allowing an individual

charged with a serious violent crime to provide

as much input into his or her case plan as an

individual charged with a minor misdemeanor.

Issues such as these underscore the importance

of clearly defined initiative parameters that are

the product of collaborative planning and design


The Essential Elements of Specialized Probation Initiatives 13

34. For more information on Moral Reconation Therapy, see the

Substance Abuse and Mental Health Services Administration’s

National Registry of Evidence-based Programs and Practices at


35. The Substance Abuse and Mental Health Services

Administration defines EBPs as “the use of current and best

research evidence in making clinical and programmatic

decisions about the care of the client.” Center for Substance

Abuse Treatment. Understanding Evidence-Based Practices

People with mental illnesses under probation supervision

require an array of services and supports,

including medication; counseling; behavioral therapy;

substance use treatment; halfway, transitional, or

supportive housing; public benefits; crisis intervention

services; peer supports; vocational training;

and family counseling. Specialized probation

initiatives should anticipate the needs of their

target population and work with community

providers to ensure that appropriate services—

particularly those required to carry out desired

case plans—will be available to participants during

community supervision.

Parameters for the type, intensity, setting,

and degree of coordination or integration of services

should be determined by the initiative’s

intended target population and refined according

to participants’ unique criminogenic risks and

functional impairments. Individuals with low risk/

low impairment can be supervised and treated

with little or no coordination. Individuals with

high risk/high impairment need integrated strategies.

These strategies can include co-location,

where services and treatment are delivered in the

supervision setting or supervision is provided in

a service and treatment setting; staff sharing,

where staff is hired by or “loaned” among collaborating

agencies; and joint initiative administration

in which supervision and case plans are developed

and reviewed.

The menu of treatments and services that are

provided by the probation agency or community

providers will vary across jurisdictions. For example,

probation agencies may contract for their own

transitional housing programs, monitor drug

abstinence requirements by conducting urinalyses,

and contract with community providers to

deliver treatments and services on premises. In

other jurisdictions, community treatment agencies

may have probation officers as part of their

case management team. In some communities,

probation agencies may have in-house staff that

provides cognitive-behavioral treatments such as

Moral Reconation Therapy to address participants’

criminogenic risks.34 In still other jurisdictions,

these treatment modalities may be part of an integrated

behavioral health approach provided by a

community mental health center that is treating

other psychiatric or substance use disorders.

Regardless of whether probation agencies

directly provide treatments and services or broker

their delivery, the specialized probation initiative

should work to ensure that evidence-based

practices (EBPs) and promising approaches

for mental health treatment are provided to

supervisees.35 If community treatment providers

6 providing or linking to treatment

and services

Probation agencies connect their supervisees to comprehensive, individualized, and

evidence-based treatment and services in the community, and work with communitybased

providers to coordinate and integrate the services that the probation agency and

the public health and social service systems can provide.

14 Improving Responses to People with Mental Illnesses

for Co-Occurring Disorders: COCE Overview Paper 5. DHHS

Publication No. SMA 07-4278 (Rockville, MD: Substance

Abuse and Mental Health Services Administration, Center

for Mental Health Services, 2007).

36. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice

Approach to Community Re-entry from Jails for Inmates with

Co-Occurring Disorders: The APIC Model (Delmar, NY: The

National GAINS Center, 2002),


37. Ibid.

38. Other EBPs for mental health treatment include illness

self-management and recovery, supported employment,

psychopharmacology, and family psychoeducation. For more

information on EBPs and promising practices, see the GAINS

Center web site at

39. Osher, F. C., and H. Steadman. “Adapting Evidence-based

Practices for Persons with Mental Illness Involved with

the Criminal Justice System,” Psychiatric Services 58 (2007):


do not have the capacity or training to implement

these practices—or more broadly, any necessary

treatments or supports—the specialized probation

initiative should advocate to increase the availability

of these services.

A number of EBPs and promising approaches

have been shown to improve clinical functioning

for people with mental illnesses and may be applicable

for people with mental illnesses involved

with the criminal justice system. First, given

the high prevalence of co-occurring substance

use disorders among individuals with mental

illnesses, it is particularly important for specialized

probation initiatives to access integrated

treatment for mental illnesses and substance

use disorders. Comprehensive, integrated efforts

help people with co-occurring disorders attain

remission and reduce substance use, hospital

utilization, psychiatric symptoms, and rearrest.36

Second, access to housing is essential to any case

plan or treatment regimen, and supported housing

is a promising practice for the successful

community reintegration of people with mental

illnesses.37 Third, trauma-informed services,

another promising practice, are also critical given

the high rates of trauma among people with

mental illnesses.38 Finally, individuals with mental

illnesses frequently require some form of case

management services. One form, assertive community

treatment (ACT), is an EBP associated

with reductions in psychiatric hospitalizations

and increases in functionality. Without modification,

ACT has demonstrated a mixed impact

on recidivism. To address this, forensic assertive

community treatment (FACT) teams have been

developed, often integrating probation officers,

and have shown promise in positively impacting

clinical outcomes and recidivism.39

In addition to linking individuals to evidence-

based treatments and services, probation

and mental health agency staff should develop

protocols for ensuring supervisees’ continuity

of care (i.e., transitioning from various settings

without changing treatment providers) in

two critical situations. First, participants may

be returned to jail for violating conditions of

supervision or for committing a new offense.

Probation officers and treatment providers

should ensure that information about supervisees’

treatment progress, medications, and other

key information is transferred to jail staff so they

can create a case plan based on this information.

Second, participants will eventually complete

their term of community supervision; probation

officers and treatment providers should ensure

they have sustained access to these treatments

and other supports when supervision ends. This

means that probation agencies and community providers

should ensure that participation in their

initiative (and more broadly, the criminal justice

system) is not the sole mechanism for access to

these services.

The Essential Elements of Specialized Probation Initiatives 15

40. The Public Safety Performance Project of the Pew Center

on the States. Policy Framework to Strengthen Community

Corrections. (Washington: The Pew Charitable Trusts, 2008).

Once individualized conditions of supervision,

a case plan, and specific treatment regimens

are established, probation officers—in collaboration

with community providers—are responsible

for ensuring that their supervisees comply with

the terms of their participation in the specialized

probation initiative. The supervision strategies

and techniques that officers employ can have

a direct impact on whether their supervisees

become further entrenched in the criminal justice

system or successfully transition to their

communities. Probation officials should ensure

that their supervision methods are consistent

with the objectives of the specialized probation


Probation agencies should view their role as

more than monitors of compliance and consider

their supervisees’ complex treatment and service

needs as integral to maintaining public safety and

reducing recidivism. Probation officers should

be provided incentives to keep individuals with

mental illnesses on their caseloads,40 with the

knowledge that “closing a case” may result in

missed opportunities to link individuals to appropriate

treatment. Likewise, community-based

treatment providers should not avoid working

with individuals with criminal charges or convictions.

These providers should view jails and

community corrections agencies as part of a continuum

of intervention settings, and mental health

officials should create incentives for providers to

implement treatments that target criminogenic


Collaborative planning and cross-training

can help ensure that probation agencies and

community treatment providers have the workforce

capacity to implement these practices and

close existing gaps in resources or competencies;

however, planning and training should be

supported by strong leadership within probation

and mental health agencies. In fact, probation

administrators across the country have changed

the culture of their agencies by articulating a

mission—and incentivizing practices—that go

beyond law enforcement and consider probation

as part of a larger constellation of services that

advance public safety and health and strengthen

communities. At the same time, many mental

health administrators have recognized their role

in improving the safety of their communities

and embraced this shared mission within their


7 supporting adherence to conditions

of community supervision and

case plans

Probation officers—in coordination with community-based treatment providers—support

individuals’ adherence to the terms of their probation with a “firm but fair” relationship

style and employ problem-solving strategies and graduated sanctions and incentives to

encourage compliance, promote public safety, and improve treatment outcomes.

16 Improving Responses to People with Mental Illnesses

41. These strategies and techniques have been explored in depth

in the literature on evidence-based and promising community

corrections practices. These community corrections EBPs and

promising practices should be distinguished from the mental

health treatment EBPs described in element 6. For more

on community corrections EBPs and promising practices,

see Crime and Justice Institute. Implementing Evidence-

Based Practice in Community Corrections: The Principles of

Effective Intervention (National Institute of Corrections, 2004), For information

on incorporating general community corrections EBPs

into broader statewide policy efforts, see The Public Safety

Performance Project of the Pew Center on the States. Policy

Framework to Strengthen Community Corrections (Washington:

The Pew Charitable Trusts, 2008).

42. Skeem, J., and J. E. Louden. “Toward Evidence-based Practice

for Probationers and Parolees Mandated to Mental Health

Treatment,” Psychiatric Services 57 (2006): 333–42.

43. Several meta-analyses of existing evaluations show that

supervisees are less likely to recidivate when programs focus

on higher risk cases, matching the intensity of supervision

and treatment services to their level of risk for recidivism (risk

principle), match modes of service to their abilities and styles

(responsivity principle), and target a greater number of their

criminogenic needs, or changeable risk factors for recidivism

(need principle). For more information, see Andrews, D. A.,

et al. “Does Correctional Treatment Work? Clinically Relevant

and Psychologically Informed Meta-analysis,” Criminology

28 (1990): 369–404 and Andrews, D. A., and J. Bonta.

The Psychology of Criminal Conduct, third ed. (Cincinnati:

Anderson, 2003).

Although all responses to supervisees’ behavior,

whether positive or negative, should be

individualized, there are general proven supervision

strategies and techniques that can reduce

probation violations for all people under community

supervision.41 Specialized probation

initiatives should ensure that the following

strategies are incorporated into their efforts.42

Officers should apply risk-needs-responsivity

principles43 and establish “firm but fair” relationships

with their supervisees that are authoritative

(not authoritarian) and characterized by caring,

fairness, and trust. Officers should use problem-

solving strategies (as opposed to relying on

threats of incarceration or other negative pressures)

to address compliance issues. For example,

if a supervisee has functional impairments that

make it difficult to adhere to standard conditions

of release, such as transporting him- or herself

to appointments, the probation officer should

meet with the supervisee to identify and resolve

these obstacles to compliance or make necessary

adjustments to supervision or case plan conditions.

In general, officers should conduct field

supervision rather than monitor individuals

remotely from a central location.

It is also important that probation officers

working on a team with mental health and

substance use treatment providers develop a

shared understanding of behaviors that constitute

a violation of the conditions of supervision.

For example, substance use relapse is common

early in the recovery process and should not

necessarily be grounds for probation revocation.

On the other hand, depending on an individual’s

level of public safety risk, functional impairment,

and/or history of dangerous behavior when

intoxicated, the response to relapse may include

a technical violation. An individual whose past

crimes were clearly related to intoxication might

warrant less tolerance. The important principle is

that responses to an individual’s behavior should

be consistent with an individual’s supervision

and case plans and reflect the team’s short- and

long-term objectives with each supervisee.

When supervisees’ behavior does constitute

a violation of their supervision conditions, the

specialized probation initiative should employ

a menu of graduated sanctions (that is, the severity

of sanctions increases with the frequency or

severity of violations) that are individualized to

maximize compliance. The manner in which

these sanctions will be applied should be explained

to supervisees before they begin participating

in the specialized initiative. Sanctions should

encourage pro-social choices and adherence to

treatment recommendations. They should avoid

disengaging individuals from community treatment.

Specific protocols should govern the use

of jail as a consequence for serious noncompliance.

In general, jail should be used only as a last

resort, and probation agencies should explore

alternatives such as intermediate-sanction facilities

or day-reporting centers, staffed by probation

officers and community treatment providers, to

The Essential Elements of Specialized Probation Initiatives 17

44. For detailed suggestions on developing state statutes that

grant officers the authority to implement graduated sanctions

for all people under probation supervision (not just those with

mental illnesses), see The Public Safety Performance Project

of the Pew Center on the States. Policy Framework to Strengthen

Community Corrections (Washington: The Pew Charitable

Trusts, 2008).

45. For example, see Solomon, P. Response to “A Model Program

for the Treatment of Mentally Ill Offenders in the Community,”

Community Mental Health Journal 35 (1999) and Solomon, P.,

and Jeffrey Draine. “One-Year Outcomes of a Randomized

Trial of Case Management with Seriously Mentally Ill Clients

Leaving Jail,” Evaluation Review 19 (1995): 256.

46. Ibid.

ensure continuity of care and prevent further

involvement with the criminal justice system.44

Probation officers should also have a menu

of incentives for sustained adherence to the conditions

of community supervision. These might

include less frequent contacts with probation

officers and treatment providers, certificates

of compliance, non-cash rewards, and in some

cases, reductions in the length of the probation

sentence. Policymakers and practitioners

involved with specialized probation initiatives

generally agree that incentives are as critical as

sanctions to supervisees’ success.

It is also important for probation and treatment

staff to recognize that, with reduced caseload

size and greater coordination and integration

between community corrections and mental

health agencies, it may be far more likely for a

team member to detect behaviors that constitute

technical violations of supervision conditions.

Treatment providers who have not historically

provided services to justice-involved individuals

may experience the “treater-turned-monitor

dilemma” in which they may be tempted to engage

in so-called “benevolent coercion” and use return

to jail as a threat to get individuals to comply

with treatment.45 Such strategies undermine the

potential benefits of collaboration between probation

agencies and community-based treatment

providers.46 The specialized probation initiative

should have clear protocols for mitigating these

phenomena in a manner that is consistent with

the initiative’s objectives.

18 Improving Responses to People with Mental Illnesses

Training should be provided to probation officers

and community-based treatment providers to

improve both systems’ responses to people with

mental illnesses under probation supervision.

Probation agencies and community providers

should work together to plan and implement a

training regimen that supports the specialized

probation initiative. Multi-disciplinary, multisystem

collaboration ensures that training reflects

an appropriate range of perspectives. This effort

should be coordinated by initiative administrators

who choose training content and techniques,

select trainers, ensure the training is culturally

competent, and evaluate the effectiveness of


Initiative administrators should consider a

number of other training issues as well. First,

they should weigh the costs and benefits of both

centralized and local training, as the former can

create efficient and uniform training for larger

jurisdictions and the latter can create opportunities

for building strong, local relationships.

Second, initiative administrators should determine

how they will select probation officers and

mental health treatment providers to receive training.

Soliciting volunteers, rather than assigning

staff to receive training, may make it less likely

that officers who have no desire to work with this

population will feel forced to do so. Recruiting

new staff who have already received training on

mental illnesses or criminal justice issues, or

who have a special interest in working with this

population, is preferable for the same reasons.

Nevertheless, probation agencies can incentivize

this type of training as a form of professional

development for staff who may not have strong

preferences either way. Third, to the greatest

extent possible, former supervisees with mental

illnesses, their family members, and peers

should be involved in training.

All probation officers, regardless of whether

they are involved with a specialized initiative,

should receive basic training on mental illness

and its impact on individuals, families, and communities;

signs and symptoms of mental

illnesses; stabilization and de-escalation techniques;

and legal issues such as confidentiality,

victim notification, and other related procedures.

Most importantly, probation staff should learn

what treatment and services are available in the

community and how to access them.

Officers involved with specialized probation

initiatives should receive more significant

and sustained training. In a survey of officers

with specialized probation caseloads dedicated

exclusively to people with mental illnesses,

8 providing specialized training and


Probation officers who supervise individuals with mental illnesses receive substantial

and sustained training on mental health issues, co-occurring substance use disorders,

and effective supervision strategies for this population. Community-based treatment

and service providers receive training on jail and probation policies and procedures, court

reporting requirements, and the scope of behavioral health services provided by jail and

community corrections staff. When possible, staff from probation and community-based

treatment agencies cross-train each other on these issues.

The Essential Elements of Specialized Probation Initiatives 19

47. Skeem, J. L., Paula Emke-Francis, and Jennifer Eno Louden.

“Probation, Mental Health, and Mandated Treatment: A

National Survey,” Criminal Justice and Behavior 33 (2006):


officers received 20 to 40 hours of training

per year.47 These officers should be trained to

employ problem-solving strategies, apply riskneeds-

responsivity principles, and use graduated

sanctions in response to noncompliance. They

should also be trained to act as boundary spanners

with the mental health and service systems

in order to actively coordinate treatments and

services with supervision.

Community-based mental health providers

working with the specialized probation initiative

should be trained in the workings of the criminal

justice system and the impact of arrest and incarceration

on individuals with mental illnesses.

They should understand legal terminology, jail

and court processes, correctional classification

systems, screening and assessment procedures,

and the range of treatments and services

provided by jail-based or specialty probation clinicians.

Treatment providers should also receive

training on when and how to report violations of

supervision conditions to probation authorities,

their role and responsibilities when warrants are

issued, and how to provide information during

court hearings. To the greatest extent possible,

mental health agencies should also receive training

on assessing and treating issues around

criminogenic risk and incorporating these practices

into their traditional behavioral health

treatment packages.

Initiative administrators and collaborating

agencies should recognize and acknowledge that

the criminal justice and mental health systems

have traditionally had different missions, and

that cultural differences exist between their agencies.

They should understand that cross-training

is necessary, but not sufficient, for reconciling

these differences, meeting shared goals, and

achieving desired outcomes. Structural supports,

policies, procedures, agency leadership, and program

and performance evaluations discussed

in the preceding and subsequent elements are

crucial for enabling specialized training to be

absorbed and implemented.

20 Improving Responses to People with Mental Illnesses

48. For more information, see Petrila, J. Dispelling Myths about

Information Sharing between the Mental Health and Criminal

Justice Systems (Delmar, NY: National GAINS Center, 2007),


Information exchange among jails, probation agencies,

and community-based treatment providers is

a prerequisite for developing case plans, linking

individuals to treatment and services, ensuring

continuity of care after periods of incarceration,

and determining appropriate supervision strategies.

In short, the success of specialized probation

responses to people with mental illnesses

can hinge on whether crucial information about

diagnoses, medications, criminogenic risk assessments,

substance use, public assistance, and other

relevant details of personal history follows people

across systems.

All information sharing must, of course,

comply with local, state, and federal statutes on

the confidentiality of mental health and/or substance

use records, such as the federal Health

Insurance Portability and Accountability Act

(HIPAA); however, HIPAA is often erroneously

cited as the reason why information crucial to

the success of specialized initiatives cannot be

shared. Planners and administrators should recognize

the widely held misconceptions about

HIPAA restrictions and work with all relevant

staff to clarify these issues.48

Information should be shared in a way that

protects and maintains individuals’ confidentiality

rights as consumers of mental health services

and their constitutional rights as defendants.

It is paramount that supervisees are educated

about and involved in addressing these issues.

Probation officers and treatment providers

should establish trusting relationships that can

mitigate information-sharing barriers. Informed

consent leading to supervisees’ signed release of

information is the most effective way to honor

confidentiality rights and create effective supervision

and treatment responses.

Planners and administrators should determine

which personnel have the authority to

request and provide information about individuals’

mental health and criminal histories.

Information exchanges should be limited strictly

to what is needed to inform appropriate supervision

and case plans. To that end, release or

consent forms should become standard interagency

procedures. They should be developed in

consultation with legal counsel; adhere to local,

state, and federal laws; and specify what information

will be released, to whom, and over what

9 sharing information and maintaining


Probation agencies and community-based treatment providers standardize a protocol for

sharing health and legal information about individuals within their shared target population,

and ensure that this procedure is understood and implemented by all relevant staff.

The information-sharing protocol is consistent with local, state, and federal privacy regulations

and facilitates the exchange of information among all components of the criminal

justice system and between the criminal justice and community-based treatment systems.

The Essential Elements of Specialized Probation Initiatives 21

49. The Bureau of Justice Assistance supports the electronic

exchange of information between agencies. To learn more

about these and other national policies, practices, and

technology capabilities that support effective and efficient

information sharing, see

period of time. Potential participants in the specialized

probation initiative should review these

forms with the advice of defense counsel and

treatment providers. To the greatest extent possible,

and especially when competency may be

at issue, staff must ensure that potential participants

understand how information will and will

not be used. Potential participants should not be

asked to sign release forms until all competency

issues are resolved.

Planners and administrators must carefully

consider the type of information needed and

existing barriers to its exchange, and then develop

procedures and memoranda of understanding

(MOUs) to ensure appropriate sharing. These

protocols should be emphasized in cross-training

sessions. Planners and administrators may

also want to consider ways to share information

electronically, by linking different agencies’ information

management systems on an ongoing or

one-time basis.49 Such arrangements, which can be

part of a broader electronic data collection system,

are expedient and efficient and can be designed to

grant and deny access to appropriate staff.

The exchange of information facilitates

communication and collaboration among law

enforcement agencies, courts, jails, community

corrections agencies, and the community-based

treatment system. For example, jail staff can

inform the courts when an individual with mental

illness is identified at intake so a judge can

determine if the person should be considered

for participation in a specialized intervention.

It is essential that information exchanges flow

in both directions—that is, criminal justice

agencies further along the continuum and community

providers should also be prepared to

send information upstream, such as when community

treatment information-sharing protocols

ensure relevant information follows an individual

back into the corrections system if probation

is revoked.

Planners and administrators should acknowledge

that although the clearly defined policies and

procedures described above are essential, they

cannot replace trusting inter-system relationships

among staff at agencies that have historically

had very different goals and cultures. Probation

officers should understand that some types of

clinical information cannot (and should not) be

shared, just as treatment providers should understand

that other types of clinical information

must be shared with probation officers to ensure

successful community supervision. The development

of these sorts of relationships is arguably as

important as the establishment of any protocols

or electronic data collection systems.

In addition to collecting and sharing data

about individual participants to improve their clinical

and legal outcomes, there is also tremendous

value in sharing aggregate data. As discussed in

Element 10, aggregate data are required to measure

the impact of the specialized initiative and

ensure its sustainability. Therefore, procedures

and MOUs that explicitly cover the exchange of

aggregate data should also be developed.

22 Improving Responses to People with Mental Illnesses

The planning committee and initiative administrators

should take steps early in the design

process to ensure that they can determine the

effectiveness of the initiative and maintain its

long-term sustainability. To this end, planners

and administrators should identify performance

measures based on initiative goals and objectives.

These measures can include process data

on key aspects of initiative operations; qualitative

data on officers’, supervisees’, and community

members’ perceptions of the initiative; and outcome

data including initiative costs and cost

offsets. Where possible, the planning committee

should also include program evaluators in the

initial planning and design processes outlined

in the preceding elements. This can be achieved

by establishing early partnerships with local universities

or identifying consultants if no in-house

researchers or evaluators are available.

The specialized probation initiative should

collect data that focus on questions most critical to

the initiative’s success. Process data include such

items as the number of people who screen positive

for mental illness, the number of people who have

attended and completed treatment programs, or

the number of contacts with probation or clinical

staff. Qualitative data could include such measures

as officers’ impressions of how time consuming,

easy, or difficult it is to supervise people with mental

illnesses, and supervisees’ impressions of the

quality of supervision and treatment they receive.

Outcome data include rates of technical violations,

revocations, and rearrest; trends in the overall

growth of the jail population; number of hospital

days and emergency room costs avoided; as

well as information about participants’ functional

improvements and symptom reductions. Initiative

funders frequently request data about cost effectiveness;

therefore, this information is of critical

concern for continued support. However, cost

effectiveness methodology is quite complex, and

if the data are not collected correctly or reported

clearly, they may not be compelling. Ideally,

data on appropriate comparison groups are also

collected to demonstrate outcomes that might have

occurred in the absence of the specialized initiative.

A feedback loop should be established that

allows these data to inform initiative refinement.

As discussed in Element 1, formalizing the

initiative’s policies and procedures is an important

component of sustaining the initiative.

Compiling information about the initiative’s history,

goals, screening and assessment protocols,

eligibility criteria, information-sharing protocols,

supervision strategies, sanctions, and incentives

helps ensure consistency and mitigates the

impact of staff turnover. It also informs ongoing

quality improvement processes and enables initiative

administrators to make adjustments when appropriate.

Planners and administrators should also garner both external and internal support. Initiative

10 conducting evaluations and ensuring sustainability

Data are collected and analyzed that demonstrate the impact of the

specialized probation initiative on revocation rates, engagement in

treatment, and the prevalence of mental illnesses in jails and prisons.

These data inform a quality improvement process that results in

modifications to the initiative. In addition, the evaluation of initiative

effectiveness is used to sustain support for the initiative.

The Essential Elements of Specialized Probation Initiatives 23

leaders should reach out to community leaders

and the media to educate them about the

public safety goals and other objectives of the

specialized probation initiative. They should also

involve key elected and appointed officials and

other policymakers as early as possible in the

initiative’s design and implementation, and keep

them involved to promote supportive legislation

and/or funding opportunities. Probation officers,

mental health treatment providers, and other personnel—

involved with the effort or not—should

also be surveyed so initiative partners can better

assess its impact and ideally develop a base of

support from within the ranks of collaborating


Planners and administrators should also

develop a crisis communication plan that builds

on the positive relationships they forge between

the specialized initiative and the community at

large, the media, and policymakers. Plan implementers

communicate that sometimes there

will be incidents involving initiative participants,

but that these rare—though often highly publicized—

events should not undermine the broader

benefits of the initiative.

In addition to calling on policymakers to

advance financial support for an initiative,

diverse funding options are key to long-term sustainability.

Although in-kind contributions from

multiple agencies can accomplish a great deal in

offsetting initiative costs, planners and administrators

should identify and cultivate additional

resources. Requests for funding should be tied

to clearly articulated initiative goals and incorporate

data that demonstrate positive outcomes.

Funding should include support for the process

and outcome research mentioned above. In

general, most local probation departments and

other local agencies participating in the initiative

do not have the expertise or staff to set up

the data collection and analysis suggested in this

document. With some outside expert assistance,

however, agency personnel may effectively be

guided to design and implement the data collection

mechanisms that consultants (for example,

graduate students supervised by an experienced

researcher from a local university) can then

analyze and report to initiative stakeholders at

appropriate intervals.

24 Improving Responses to People with Mental Illnesses

Probation agencies across the country are seeing

increasing numbers of people with serious

mental illnesses on their caseloads. Traditional

community supervision strategies are associated

with poor outcomes for these individuals;

they are twice as likely as people without mental

illnesses to have their probation revoked and

become further entrenched in the criminal justice

system. As a group, they can be challenging

to supervise. They have broad treatment and service

needs and require supervision strategies that

traditional probation agencies were not designed to provide.

Recognizing the need for innovative

approaches, probation agencies and communitybased

treatment providers across the country are

working to develop creative interventions that

address the unique needs of their overlapping

target populations. These agencies are engaged

in problem solving with an array of partners

from a range of disciplines. Together they are

utilizing a growing knowledge base about what

works, for whom, and under what circumstances.

What the field has lacked is a concise construct

of the essential elements of successful specialized

probation responses to people with mental

illnesses. This publication draws on the broad

accumulation of information and the experiences

of probation agencies and mental health

treatment providers to fill that gap. It is hoped

that these elements will help guide policymakers

and practitioners who are initiating or enhancing

their own initiatives.

The tone of this document may suggest

that the changes recommended above are easy

to make. They are not. There are many challenges,

including complex politics, turf battles,

competition for limited funding, and scarce probation

and community mental health resources.

Despite these obstacles, probation agencies and

their community partners have demonstrated a

willingness to coalesce around shared goals and

purposes to address these difficult issues. These

essential elements are written for such innovators

and those who will follow in their footsteps,

all of whom work tirelessly to make communities

safer and healthier, use public resources

and tax dollars efficiently and effectively, and

improve outcomes for people with mental illnesses

who become involved with the criminal

justice system.


Nationwide, approximately two million adults with serious mental illnesses are admitted into jails each year. In many communities, people with mental illnesses are detained while awaiting trial at higher rates and for longer periods of time than those without these needs, despite recent evidence that suggests that pretrial detention can increase future involvement in the criminal justice system.

Increasingly, local leaders have come together to develop new policies and practices, guided by a growing base of research and experience. Communities are beginning to allocate more resources for training, universal screening for behavioral health needs, research-based tools to inform release and diversion decisions, the use of evidence-based treatment and supervision approaches, and data collection and analysis. These strategies are critical not only for public safety and public health, but also to maintain the responsible use of public resources. The experiences in these communities and the contributions made by researchers in recent years inform the essential elements described herein, which can serve as a foundation for communities around the country.

As recognized throughout this publication, the pretrial stage of a criminal case presents great opportunities for improvement, in addition to the real challenge of crafting policies and processes that strike a balance between making well-informed decisions quickly while protecting individual liberties and making lasting connections to needed care. Despite substantial advances in the last several years, there are still significant unanswered questions about what works best for whom. These elements encourage data collection not only to help individual communities, but also for future researchers who are dedicated to these important questions.

Council of State Governments

Justice Center

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